Provider Demographics
NPI:1972527091
Name:CARTER, MICHELE LEIGH (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:LEIGH
Last Name:CARTER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2723 CHRYSLER DR
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:NM
Mailing Address - Zip Code:88201-5207
Mailing Address - Country:US
Mailing Address - Phone:575-914-5533
Mailing Address - Fax:
Practice Address - Street 1:711 W ALAMEDA ST
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:NM
Practice Address - Zip Code:88203-4403
Practice Address - Country:US
Practice Address - Phone:575-622-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2015-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD27511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice